NEUROLOGICAL SURGERY RESIDENCY
NEUROLOGICAL SURGERY RESIDENCY
The Methodist Hospital’s Department of Neurosurgery is an integral
part of The Methodist Neurological Institute. The residency program in
Neurological Surgery was accredited by the ACGME in July 2005. The
goal of the training program is to develop the intellectual, technical, and
professional competencies of the residents, and to prepare them for their
future careers in practice and in research. We are interested in training
neurosurgeons for both academic and practice settings.
The Neurological Institute has a faculty with a broad range of subspecialty
experience, extensive facilities, and is located in a city whose metropolitan
area has a population of over ﬁve million people. Over 3,500 major
neurosurgical procedures and 400 interventional neuroradiological procedures
were performed at the Neurological Institute in the past year. The Institute
currently has a staff of 13 neurosurgeons, 8 neurologists, and 10 neuroradiologists.
O R G A N I Z AT I O N
The Methodist Hospital Residency in Neurological Surgery is a six-year
program after the year of general surgery training, through which one resident
each year matriculates. Application to the program is made through
correspondence with the Central Application Service and David S. Baskin,
M.D, the Program Director. Completed applications, transcripts, letters of
recommendation, etc., are forwarded by the application service to the Ofﬁce
of the Program Director. Applications are reviewed and interviews are conducted
by the active teaching staff.
The training plan is directed towards the goal of providing the resident
with the core knowledge and experience necessary to graduate as a
competent neurological surgeon. The plan is further directed towards
preparing the resident for successful examination by the American Board
of Neurological Surgery.
Each resident is expected to develop and complete a clinical or basic research
project during the research year described below. Ample research opportunities
are available to the resident at the Methodist Hospital, and via numerous
collaborations throughout the Medical Center. The department will have
almost 4,000 square feet of research space available in January of 2006,
including wet lab space with state of the art molecular biology capabilities,
as well as an experimental surgery operating room for developing microsurgery
skills, neuroanatomy dissections, and sterile surgery. A Bio Containment
Level 2 hood is available for gene therapy and/or stem cell implantation ATTENDING
procedures. Ongoing projects include work with glioblastomas, experimental
stroke and spinal cord injury, and nanotechnology using nano-machines and PHYSICIANS
nanotubes with speciﬁc labels attached. In addition, there is space available
with state-of-the-art radiological equipment for vascular neurosurgery
research in conjunction with Neuroradiology. Yet another laboratory TEAM A
experience is available in spinal cord injury and regeneration at the
Methodist Hospital, through collaborations with the Christopher Reeve James Rose, M.D.
Paralysis Foundation. Todd Trask, M.D.
David Baskin, M.D.
In addition, the Department has afﬁliations with the University of Houston,
which has an extensive research program with interests in neuro-engineering, Robert G. Grossman, M.D.
frameless navigation, and MR imaging, including spectroscopy, diffusion Richard Harper, M.D.
tensor imaging, and functional MRI imaging. There are also interests in David Cech, M.D.
developing artiﬁcial intelligence via novel computer programs and simulations.
SUMMARY OF THE METHODIST H O S P I TA L TEAM B
NEUROSURGERY RESIDENCY PR O G R A M
The service at the Methodist Hospital is divided into two teams for the
J. Bob Blacklock, M.D.
educational purposes, and for efﬁcient care by subspecialty areas. Team A Daniel Yoshor, M.D.
predominantly performs vascular, brain tumor, skull base, and radiosurgery. Rob Parrrish, M.D., Ph.D.
Team B predominantly performs epilepsy, functional, complex spine
surgery, and peripheral nerve surgery. Both teams perform simple spine
Richard Simpson, M.D., Ph.D.
surgery. Attendings on one team may perform a type of surgery predominantly Al Aldama, M.D.
performed by the other team. In such instances, residents will continue to Bruce Ehni, M.D.
work with the attendings on their team.
Warren Parker, M.D.
FIRST YEAR (NS-1) THIRD YEAR (NS-3):
The ﬁrst year at The Methodist Hospital provides the resident At The Methodist Hospital, the NS-3 resident performs more
with an in-depth overview of neurological history taking and advanced procedures and assumes more administrative duties.
physical examination, the spectrum of neurosurgical disease, The resident spends 6 months with the faculty of the Team A
the indications and contraindications for surgery, management and 6 months with Team B.
of critically ill patients in an intensive care setting, and an
overview of operative techniques. The NS-1 resident spends The resident is expected to plan a research project that will
6 months on each team. The ﬁrst-year neurosurgical resident continue into the fourth year.
operates on a wide variety of cases with the attending physicians
and is responsible for the care of patients in the neurosurgical The NS-3 resident plans the morning clinical conferences at
intensive care unit with the assistance of the NS-3 resident, The Methodist Hospital. At the end of the year of training, the
under the supervision of the chief resident and the attending resident should be able to be the primary surgeon on the most
physicians. Experience in the neurosurgery intensive care unit standard neurosurgical procedures.
occurs throughout the year under the direction of Dr. Todd
Trask, Medical Director of the NICU, as well as by interactions FOURTH YEAR (NS-4)
with consultants. The NS4 year is dedicated to laboratory or clinical research
without interruption for call responsibilities. The resident can
By the end of the ﬁrst year, the resident has acquired skill in work in one of the laboratories in the department or elsewhere.
the work-up and management of patients and the recognition of Financial support for this year includes salary. If the resident is
preoperative and post-operative problems, is familiar with most located away from Houston, The Methodist Hospital will cover
neurosurgical procedures, and is competent to manage critically the resident’s travel and room and board expenses.
ill patients in an ICU setting. The resident will be able to
perform ventriculostomies, place lumbar drains, open and close During this time, the resident may continue a project started in
craniotomies, perform peripheral nerve explorations, and perform the NS-2 and NS-3 years. Our experience has shown that, by
decompressive lumbar laminectomies. initiating projects in already functioning laboratories, the residents
are able to complete research projects in the areas of intracranial
SECOND YEAR (NS-2) pressure and blood ﬂow analysis, ischemia protection, brain tumor
During the second year, the resident reﬁnes diagnostic, clinical, and biology and treatment, and gene therapy for brain tumors. Support
laboratory skills during rotations on the neurology, neuroradiology, is available for study design, biostatistical, and manuscript and/or
and neuropathology services. Second-year residents should also poster presentation. Residents are expected to submit a minimum
identify a research project for their research year, in consultation of one manuscript to the neurosurgical journal and an abstract to
with the Program Director. the neurosurgical meeting during the fourth year.
The rotation in Neurology reﬁnes the resident’s history-taking and FIFTH YEAR (NS-5):
physical examination skills, exposes the resident to comprehensive The year is divided into three 4-month blocks. During one of
inpatient and outpatient management of neurologic disease these times, the resident will spend 4 months in Pediatric
including the use of electrophysiology, and helps to develop the Neurosurgery at New York Presbyterian Hospital. The resident
resident’s judgment in the selection of cases for surgery. Each will work closely with the full-time faculty and will have operative
resident spends 4 months on the Neurology service. Rotations responsibility for a wide variety of pediatric neurosurgical cases.
for TMH residents are at the Memorial Hermann Hospital The resident will also work closely with the neuroradiology,
under the direction of Dr. James Ferrendelli, Chairman of the neuropathology, and neurology services. Expenses including travel
Department of Neurology at The University of Texas Medical and housing will be paid for by the residency training program.
School at Houston, and at the Methodist Hospital under the
direction of Dr. Stanley Appel, Chairman of the Department The other 8 months will consist of enfolded subspecialty experiences
of Neurology at the Methodist Hospital. Neurology residents at The Methodist Hospital, in two 4-month blocks. The resident
from the University of Texas Medical School at Houston will can select two rotations from the following subspecialties: Vascular;
rotate at the Methodist Hospital starting in July 2005. Both brain tumors and radiosurgery; complex spine; stereotactic,
neurology services are outstanding in the diagnosis and functional, and epilepsy; or interventional neuroradiology.
management of epilepsy and stroke, areas of great importance
to neurosurgical treating. SIXTH YEAR (NS-6):
The last year of training is spent as chief resident at The Methodist
On the Neuropathology rotation at The Methodist Hospital, Hospital. The chief resident has administrative responsibility
the resident has primary responsibility for the initial reading of for supervising senior and junior residents and medical students,
frozen and permanent sections and participates in brain cutting. scheduling all activities of the Neurosurgical Service, and for
The resident works closely with Dr. Suzanne Powell, Program organizing the clinical and basic material presented at the conferences,
Director of Pathology Residency Training Program at The including tracking and presentation of morbidity and mortality.
Methodist Hospital. Residents learn contemporary techniques
for analyzing tissues. The chief resident performs all major surgery under the supervision
of the attending staff. There will be a chief resident service
On the Neuroradiology rotation, the resident is exposed to established with appropriate attending supervision for uninsured
myelograms, interventional neuroradiology, kyphoplasties, and patients, which the hospital will support.
vertebroplasties. Residents also participate in the daily reading
of diagnostic imaging studies. During this year as well as in the previous years, the resident has
experience in the subspecialty areas of neurosurgery.
THE METHODIST HOSPITAL
THE METHODIST HOSPITAL
The Methodist Hospital System is a nonproﬁt health care organization based in
Houston, Texas. It has extended the world-renowned clinical and service excellence
of its founding entity, The Methodist Hospital, through a network of community-
Afﬁliated with the Texas Annual Conference of the United Methodist Church,
The Methodist Hospital system works closely with local church leaders to bring
compassion and spirituality to all of its endeavors and to help meet the health
needs of the community it serves.
A legacy of medical milestones has attracted patients from around the world to
Methodist for more than 80 years. In 1996, The Methodist Hospital System
was established to extend TMH’s health services beyond the Texas Medical Center
and into communities throughout Houston. Its international physician referral
network—with information centers in Guatemala City and Mexico City and medical
afﬁliations with hospitals spanning four continents—has extended the Methodist
reach into the world community as well.
The Methodist Hospital, Houston
Methodist Sugar Land Hospital, Sugar Land
Methodist Willowbrook Hospital, Houston
San Jacinto Methodist Hospital, Baytown
Corporate Financial Information (2003):
$1.09 billion in net patient revenue
$296 million in uncompensated charity care and community beneﬁt activities
AA bond rating
The Methodist Hospital is afﬁliated with the Weill Medical College of Cornell
University and New York-Presbyterian Hospital, two of the nation’s leading
centers for medical education and research. Methodist is also afﬁliated with The
Menninger Clinic, a national specialty psychiatric and behavioral hospital, ranked
as one of “America’s Best Hospitals.”
Methodist is named among the country’s top hospitals for neurology and
neurosurgery; heart and heart surgery; urology; ear, nose and throat; psychiatry;
ophthalmology; and gynecology in U.S. News and World Report’s 2005 annual guide
to “America’s Best Hospitals.” In addition, the hospital is consistently ranked as
most preferred by National Research Corporation’s annual public opinion survey.
Methodist’s medical staff includes hundreds of physicians listed in The Best Doctors
in America who, along with other health professionals, offer expert preventive services,
diagnosis, treatment and follow-up care in virtually every medical specialty. The
Methodist Hospital System has been recognized by Hospitals and Health Networks
as one of health care’s “100 Most Wired” for its use of Internet technologies to
connect with patients, physicians and nurses, employees, suppliers, and health plans.
At 8,778 square miles, the Greater Houston area covers more ground than any other major
city in America. In fact, we’re as big as the entire countries of Israel and El Salvador.
Most of the communities here spotlight the beauty of Houston, made possible by its proximity
to several waterways. Called the Bayou City, Houston is home to more than 10 of these winding
waterways that not only irrigate the lush landscape, but also serve as green spaces for ﬁtness
and nature enthusiasts. Several lakes and bays also provide pleasant scenes of fun in the sun as
well as a feast for the eyes.
Beyond beauty, it’s the business opportunities provided by Houston’s waterways that are the
primary reasons for the city’s existence. The Port of Houston still thrives today, thanks to the
dredging of Buffalo Bayou to form the famous Houston Ship Channel. The port area is just
one of the many business districts that have branched out from the inner city. Other areas
such as the Uptown/Galleria area, Greenway Plaza, Interstate 10’s Energy Corridor and, of
course, the Texas Medical Center, are booming with business development and shortening
the commute for many Houston residents. But public transportation and Houston’s excellent
freeway system can still connect Houston’s 3 million-plus people to our revitalized downtown
Houston’s strong economy has brought with it a diverse population, which has worked to
enhance our high standards of excellence in two critical areas—education and worship. The
Houston area consistently leads all of Texas in the number of exemplary schools, and because
of our cultural diversity, the Houston Independent School District—just one of the many
districts in the area—serves students who speak dozens of languages.
The international city is also home to 45 religions, from African Methodist to Zoroastrian.
For all the far-reaching inﬂuences brought together in Houston, our neighbors still share a
common goal—the quality of life found in close-knit communities located within one
metropolitan melting pot.
ABOUT THE TEXAS MEDICAL CENTER throughout Houston and the surrounding communities, and
even in other parts of Texas and the world.
The Methodist Hospital is an integral part of the Texas Medical
Center, and facilities in the Center are available to Residents in In the Texas Medical Center, there is something to meet every-
the Neurological Training Program. body’s needs. The county’s two trauma facilities are located in the
center, as are institutions specializing in every imaginable aspect of
The Texas Medical Center started with a dream to create a health care, including care for children, cancer patients, heart care,
medical center, where people from all walks of life could have organ transplantation, terminal illness, mental health, and wellness
access to the best health care anywhere - whether they were rich, and prevention.
poor, famous, alone, young, or old.
All 42 of the Texas Medical Center’s member institutions are
In the more than 50 years since that dream originated, it has not-for-proﬁt, and are dedicated to the highest standards of
been realized many times over. The Texas Medical Center today patient and preventive care, research, education, and local,
has 42 member institutions that each exists to serve all of man- national, and international community well-being. These
kind. On any given day, one can ﬁnd people from every social institutions include 13 renowned hospitals and two specialty
circumstance and many of the world’s nations seeking treatment institutions, two medical schools, four nursing schools, and
at the center’s renowned institutions. schools of dentistry, public health, pharmacy, and virtually all
health-related careers. It is where one of the ﬁrst, and still the
Many of the member institutions are working to make the Texas largest, air emergency service was created; a very successful
Medical Center quality of care convenient to even more people inter-institutional transplant program was developed; and more
by putting clinics, ofﬁces, and other facilities in neighborhoods heart surgeries are performed than anywhere else in the world.